Individual
STEPHANIE ROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED PRACTICAL N
Contact information
Practice address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4009
Mailing address
1435 SALTERS TOWN RD, SUMTER, SC 29153-9465
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
291175
PA
Other
Enumeration date
12/22/2017
Last updated
12/22/2017
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